WALANT (Wide Awake Local Anesthesia No Tourniquet)
OVERVIEW
Wide Awake Local Anesthesia No Tourniquet (WALANT) is a technique for hand and wrist surgery that uses local anesthesia. This technique offers many advantages over standard procedures including no general anesthesia, better surgical outcomes and lower costs. With the appropriate operation, WALANT can be a better solution that may cost less.
DESCRIPTION
WALANT is a new type of local anesthesia for various hand and wrist surgery procedures. Until recently, certain hand and wrist surgeries were performed using a tourniquet to control blood to improve the surgeon’s visibility of the operated area. Tourniquets, however, are uncomfortable and unpleasant for patients. In the past, this discomfort was reduced by sedating patients with general anesthetics. (General anesthetics are used to cause a patient to remain unconscious during surgery.)

WALANT eliminates the need for tourniquets and general anesthesia (sedation) by using two medications administered locally for a safe, painless surgery. Lidocaine blocks pain, and epinephrine stops bleeding. Epinephrine acts as a vasoconstrictor to control bleeding, which is why the use of tourniquets can be eliminated during the procedure. While not every hand and wrist surgery can be performed with WALANT, there are many that qualify, some of which include:
- Nerve compression
- Tendon disorders or repairs
- Carpal tunnel release
- Trigger finger release
- Finger sensory block
- Soft-tissue Finger lesions
- PIP fusions
- Thumb MCP fusions
- Collateral ligament tears of the MCP joint
- Dupuytren contractures
- Flexor tendon repairs
- Trapeziectomy or Bennett fracture
- Metacarpal fractures
- Ligament repairs
- Fracture fixation
- Arthritic conditions
- Mass removal

ADVANTAGES
The patient advantages of using WALANT are:
- No cost/ time lost for preoperative testing for sedation, since there is no general sedation.
- Less expensive procedure. Since there is no general sedation, the procedure is not as costly.
- Less time at the hospital or surgery center for the procedure as there is little to no recovery time from the surgical procedure.
- If desired, patients can see and feel repaired structures working during the surgery after a loss of function, which helps motivate the patient in post-operative therapy and recovery.
- No need for a tourniquet.
- No need to fast or change medication schedules which is particularly helpful for diabetics.
- Increased safety. The elimination of general sedation increases safety. All research shows that WALANT is safe.
Overall, WALANT provides a less expensive and easier surgical experience, making it an effective choice for patients.
NEXT STEPS
Contact your Florida Orthopaedic Institute hand and wrist surgeon to find out if your surgery can be done with WALANT.
Areas of Focus
- Hand & Wrist
- Basal Joint Surgery
- Carpal Tunnel Syndrome
- Colles’ Fractures (Broken Wrist)
- De Quervain's Tenosynovitis
- Dupuytren’s Disease
- Finger Dislocation
- Flexor Tendonitis
- Fractured Fingers
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- Hand & Finger Replantation
- Hand Nerve Decompression
- Hand Skin Grafts
- Nerve Pain
- Peripheral Nerve Surgery (Hand) Revision
- Revascularization of the Hand
- Rheumatoid Arthritis Of The Hand
- Sports Wrist and Hand Injuries
- Sprained Wrist Symptoms and Treatment
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Thumb Ulnar Collateral Ligament Injuries
- Trigger Finger
- Ulnar Neuritis
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Tendonitis
The following Florida Orthopaedic Institute physicians specialize in WALANT:
Specialties
- AC Joint Injuries
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion Surgery
- Anterior Cervical Corpectomy & Discectomy
- Arthritis & Adult Reconstruction Surgery
- Arthroscopic Articular Cartilage Repair
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopic Rotator Cuff Repair
- Arthroscopy Of the Ankle
- Articular Cartilage Restoration
- Artificial Disk Replacement (ADR)
- Aspiration of the Olecranon Bursa
- Atraumatic Shoulder Instability
- Avascular Necrosis (Osteonecrosis)
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Bone Cement Injection
- Bone Growth Stimulation
- Bone Health Clinic
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- Charcot Joint
- Chiropractic
- Clavicle Fractures
- Colles’ Fractures (Broken Wrist)
- Common Foot Fractures in Athletes
- Community Outreach
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Degenerative Disk Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discectomy
- Discitis Treatment & Information
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot Stress Fractures
- Foot, Ankle & Lower Leg
- Foraminotomy
- Fractured Fingers
- Fractures Of The Shoulder Blade (Scapula)
- Fractures Of The Tibial Spine
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- General Orthopedics
- Glenoid Labrum Tear
- Golfer's Elbow
- Groin Strains and Pulls
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus Surgery - Cheilectomy
- Hammer Toe
- Hamstring Injuries
- Hand & Finger Replantation
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hand, Wrist, Elbow & Shoulder
- Heat Injury/Heat Prostration
- High Ankle Sprain (Syndesmosis Ligament Injury)
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Impingement Labral Tears
- Hip Muscle Strains
- Hip Pointers and Trochanteric Bursitis
- Hyperextension Injury of the Elbow
- Iliopsoas Tenotomy
- Iliotibial Band Syndrome
- Impingement Syndrome of the Shoulder
- Interlaminar Implants
- Interlaminar Lumbar Instrumental Fusion: ILIF
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Knee & Leg
- Kyphoplasty (Balloon Vertebroplasty)
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Laminectomy: Decompression Surgery
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- Little League Shoulder
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- Lumbar Epidural Steroid Injection
- Lumbar Interbody Fusion (IBF)
- MACI
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- Nerve Pain
- Neuromas (Foot)
- Neurosurgery
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Physician Or A Podiatrist?
- Orthopedic Trauma
- Osteoarthritis of the Hip
- Osteoporosis
- Outpatient Spine Surgery
- Partial Knee Replacement
- Patellar Fracture
- Pelvic Ring Fractures
- Peripheral Nerve Surgery (Hand) Revision
- Pinched Nerve
- Piriformis Syndrome
- Piriformis Syndrome
- Plantar Fasciitis
- Podiatry
- Primary Care Sports Medicine
- Quadriceps Tendon Tear
- Radial Tunnel Syndrome (Entrapment of the Radial Nerve)
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- Rotator Cuff Tears
- Runner's Knee
- Sacroiliac Joint Pain
- Sciatica
- Scoliosis
- Senior Strong
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Injury: Pain In The Overhead Athlete
- Shoulder Replacement
- Shoulder Separations
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Foot Injuries
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sports Wrist and Hand Injuries
- Sprained Ankle
- Sprained Wrist Symptoms and Treatment
- Subacromial Decompression
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow
- Thigh Fractures
- Thigh Muscle Strains
- Thumb Ulnar Collateral Ligament Injuries
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement Surgery
- Trapezius Strain (Muscle Strain of The Upper Back)
- Traumatic Shoulder Instability
- Triceps Tendonitis
- Trigger Finger
- Turf Toe
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wound Care
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Tendonitis
Services
- Physical Medicine & Rehabilitation
- Physical Therapy
- Primary Care Sports Medicine
- PROMs (Patient-Reported Outcome Measures)
- Same-Day Orthopaedic Appointments Now Available
- Sports Medicine
- Sports-Related Concussion Treatment
- Telehealth Page
- Telemedicine
- Workers' Compensation
- Workers' Compensation Dispensary
- X-Ray